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282667

Phenotypic Detection of Carbapenem Resistant Enterobacteriaceae Isolates and Assessment of Their Susceptibility to the Novel Ceftazidime-Avibactam Combination

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Last updated: 05 Jan 2025

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Abstract

Background: Carbapenems have become one of the last lines of antimicrobials against Gram negative resistant microorganisms. But in last few years, Carbapenem Resistant Enterobacteriaceae (CRE) have been reported all over the world. Numerous phenotypic tests have been planned for detection of carbapenemase activity including the newer modified Carbapenem Inactivation Method (mCIM). There is a strong need for new antibiotics to mitigate the growing threat of antimicrobial resistance (AMR). Objectives: Evaluation of the mCIM as a new method for phenotypic detection of carbapenemase-producing CRE and to test the in vitro susceptibility of the isolates to ceftazidime-avibactam. Methodology: Total of 25 CRE, isolated from 120 clinical specimens then identified by conventional methods over a 6 months period from Intensive Care Units of Surgery Department of Ain Shams University Hospitals. Phenotypic detection of carbapenemase-producing CRE was done by mCIM method compared to meropenem E-test as well as testing the susceptibility of isolates to ceftazidime- avibactam by E test. Results: Twenty-five CRE isolates were detected by meropenem disk diffusion method [Klebsiella pneumoniae (n=19) and E.coli (n=6)]. mCIM was positive for 23 out of 25 isolates (92%) showing 100% sensitivity, 66.6% specificity and 96% accuracy. There is an excellent agreement between meropenem E-test and modified CIM (kappa =0.77; P value >0.001). Twenty-two of CRE isolates (88%) were sensitive to ceftazidime- avibactam. Conclusion: The mCIM method is simple, less subjective, cost effective, sensitive method and plays an important role in detection of CRE. Also, Ceftazidime-avibactam appears to be a promising agent for the treatment of serious CRE infections.

DOI

10.21608/ejmm.2019.282667

Keywords

Carbapenem Resistant Enterobacteriaceae (CRE), Phenotypic Detection of Carbapenemase-producing CRE, modified Carbapenem Inactivation Method (mCIM), ceftazidime- avibactam susceptibility

Authors

First Name

Dalia

Last Name

Ibrahim

MiddleName

M.

Affiliation

Department of Medical Microbiology and Immunology, Ain Shams University, Cairo, Egypt

Email

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City

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Orcid

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First Name

Shereen

Last Name

Taha

MiddleName

E.

Affiliation

Department of Medical Microbiology and Immunology, Ain Shams University, Cairo, Egypt

Email

dr_shereentaha@med.asu.edu.eg

City

-

Orcid

0000-0003-3465-4494

First Name

Shimaa

Last Name

Abdel Salam

MiddleName

A.

Affiliation

Department of Medical Microbiology and Immunology, Ain Shams University, Cairo, Egypt

Email

shimaa_ahmed@med.asu.edu.eg

City

-

Orcid

0000-0002-9825-5233

First Name

Abd El Aziz

Last Name

Abd El Aziz

MiddleName

A.

Affiliation

Department of Anesthesia, Intensive Care and Pain Management, Ain Shams University, Cairo, Egypt

Email

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City

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Orcid

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Volume

28

Article Issue

2

Related Issue

39228

Issue Date

2019-04-01

Receive Date

2023-01-28

Publish Date

2019-04-01

Page Start

37

Page End

44

Print ISSN

1110-2179

Online ISSN

2537-0979

Link

https://ejmm.journals.ekb.eg/article_282667.html

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https://ejmm.journals.ekb.eg/service?article_code=282667

Order

282,667

Type

New and original researches in the field of Microbiology.

Type Code

2,038

Publication Type

Journal

Publication Title

Egyptian Journal of Medical Microbiology

Publication Link

https://ejmm.journals.ekb.eg/

MainTitle

Phenotypic Detection of Carbapenem Resistant Enterobacteriaceae Isolates and Assessment of Their Susceptibility to the Novel Ceftazidime-Avibactam Combination

Details

Type

Article

Created At

28 Dec 2024